Brent Gary Mollon, MD FRCSC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

P93557 Issued in NY

Practice address

301 E 17TH St
Room 1402
New York, NY 10003-3804

Phone

(212) 598-6000

Fax

(212) 598-6581

NPI assigned

Jul 30, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1356759682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "address_2": "ROOM 1402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "917-825-6595",
            "fax_number": "212-598-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E 17TH ST",
            "address_2": "ROOM 1402",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033804",
            "telephone_number": "212-598-6000",
            "fax_number": "212-598-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLON",
        "first_name": "BRENT",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "MD FRCSC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "P93557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mollie Eliasof LCSW Therapy PLLC
• Robert Neal Mollinger, PHD
• Sara Mollins, PSY.D.
• Patrick Mollison
• Wade Mollison
• Brian Euseph Molloy
• Christina Theresa Molloy, NP
• Mary Galaxie Molloy, APRN
• Anthony Mollura, MD
• Molly Bates LCSW PLLC

• Orthopaedic Surgery Physician in New York, NY
• Providers in New York, NY by specialty
• Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.